Health leaders: World far from ready for flu pandemic

Jun 23, 2008 (CIDRAP News)  The world is far from being well prepared for an influenza pandemic, leading national and international health officials warned at a meeting in Malaysia last week.

As the H5N1 avian influenza virus continues to thrive in birds, there is no vaccine that can provide sure protection if it evolves into a pandemic strain, and governments are paying less attention to the threat, officials said.

"We are a long way from being fully prepared, said Dr. Julie Gerberding, director of the US Centers for Disease Control and Prevention (CDC), according to a Bloomberg News report published today. She spoke at the International Congress on Infectious Diseases in Kuala Lumpur, Malaysia.

"We do not have a vaccine that will provide universal protection, we do not have surveillance in every country, we do not have control of the virus in animal reservoirs, and we have huge gaps in our basic understanding of influenza," Gerberding said.

She warned against complacency stemming from either misplaced confidence that a solution is at hand or a belief that nothing can be done to stop a pandemic, according to the story.

An Associated Press (AP) report quoted Gerberding as saying, "Public health enemy No. 1 is the challenge of complacency and our inability to maintain a focus on threats when they are around the corner or potentially in our backyard." However, she also said much progress has been made in pandemic preparations, the AP reported.

David Heymann, the World Health Organization's (WHO's) assistant director-general for health security and environment, said governmental attention to the pandemic threat has waned, according to the Bloomberg report.

"Certainly at higher levels in many governments there is no longer the concern there was five years ago," Heymann said.

He noted that many countries have written pandemic plans and are stockpiling antiviral drugs, but he agreed with Gerberding that the world "is not prepared as far as vaccines go," Bloomberg reported.

Juan Lubroth, senior officer in the infectious diseases group at the United Nations Food and Agriculture Organization (FAO), said a stronger response to the H5N1 outbreaks in poultry 5 years ago might have prevented it from spreading from East Asia to the Middle East, Europe, and Africa, the Bloomberg report said.

Lubroth said the FAO's efforts to drive H5N1 out of poultry are being hindered by poor surveillance systems in some countries and "donor fatigue."

The assessments from Gerberding, Heymann, and Lubroth contrast to a degree with recent comments from David Nabarro, the UN's influenza coordinator. At a Jun 17 news conference, he said pandemic preparedness was "really improving," though he expressed concern that the virus is still entrenched in Vietnam, Bangladesh, India, Egypt, and Indonesia.

Larger vaccine stockpile?In other news from the Malaysia conference, Heymann said a committee of experts would meet in November to discuss whether the WHO should plan to build a larger stockpile of prepandemic H5N1 vaccines, according to a Reuters report published yesterday.

So far, two drug companies, GlaxoSmithKline and Sanofi Pasteur, have pledged to provide a total of 110 million doses of H5N1 vaccines for the WHO stockpile. The WHO has said the stockpile would be used to help battle the initial emergence of a potential H5N1 pandemic and to provide vaccine to countries that would have little access to it.

Heymann said a WHO advisory committee "will determine whether or not there should be a greater stockpile or even consider vaccinating populations against H5N1 as an insurance policy," Reuters reported. He made the comments in a news conference at the Kuala Lumpur meeting.

He warned that widespread use of the vaccines could backfire if they cause serious side effects. "If they are severe, it may cause concern and might even derail activities to vaccinate in the future," he said.

Heymann said the committee would also discuss whether the prepandemic vaccines are safe and whether they provide protection against different H5N1 strains, Bloomberg reported.